Effects of different strength training frequencies on maximum strength, body composition and functional capacity in healthy older individuals

Resistance Exercise Minimal Dose Strategies for Increasing Muscle Strength in the General Population: an Overview

Many individuals do not participate in resistance exercise, with perceived lack of time being a key barrier. Minimal dose strategies, which generally reduce weekly exercise volumes to less than recommended guidelines, might improve muscle strength with minimal time investment. However, minimal dose strategies and their effects on muscle strength are still unclear. Here our aims are to define and characterize minimal dose resistance exercise strategies and summarize their effects on muscle strength in individuals who are not currently engaged in resistance exercise. The minimal dose strategies overviewed were: "Weekend Warrior," single-set resistance exercise, resistance exercise "snacking," practicing the strength test, and eccentric minimal doses. "Weekend Warrior," which minimizes training frequency, is resistance exercise performed in one weekly session. Single-set resistance exercise, which minimizes set number and session duration, is one set of multiple exercises performed multiple times per week. "Snacks," which minimize exercise number and session duration, are brief bouts (few minutes) of resistance exercise performed once or more daily. Practicing the strength test, which minimizes repetition number and session duration, is one maximal repetition performed in one or more sets, multiple days per week. Eccentric minimal doses, which eliminate or minimize concentric phase muscle actions, are low weekly volumes of submaximal or maximal eccentric-only repetitions. All approaches increase muscle strength, and some approaches improve other outcomes of health and fitness. "Weekend Warrior" and single-set resistance exercise are the approaches most strongly supported by current research, while snacking and eccentric minimal doses are emerging concepts with promising results. Public health programs can promote small volumes of resistance exercise as being better for muscle strength than no resistance exercise at all.

Different resistance training volumes on strength, functional fitness, and body composition of older people: A systematic review with meta-analysis

Aging causes several changes in the body, reducing strength and muscle mass, which leads to a decline in function. Resistance training (RT) is used to counteract these changes. However, there is still ongoing debate about the optimal volume of RT in the context of aging. We systematically reviewed articles that assessed the impact of different volumes of RT on muscular strength, functional fitness, and body composition of older people. We conducted a systematic search in the PubMed/MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, LILACS, PEDro, and Google Scholar databases, using keywords related to the older population and various RT volumes. We performed meta-analyses for each outcome separately using intervention time in weeks for subgroup analyses. We employed random effects models for all meta-analyses and expressed the results as standardized mean differences (Hedges' g). We included 31 studies, encompassing a total of 1.744 participants. The sample size ranged from 18 to 376, with an average size of 56 participants. Participants' ages ranged from 60 to 83 years. On average, HV-RT (High-Volume Resistance Training) induced significant adaptations in muscle strength of the upper limbs (g = 0.36; 95 % CI = 0.11-0.61) and lower limbs (g = 0.41; 95 % CI = 0.23-0.59), with superiority more pronounced after 12 weeks of training. Regarding functional fitness, there was a tendency favoring HV-RT (g = 0.41; 95 % CI = 0.23-0.59). Thus, HV-RT outperforms LV-RT (Low-Volume Resistance Training) in enhancing muscle strength, particularly in longer interventions with independent older adults.

Two-week step-reduction has limited negative effects on physical function and metabolic health in older adults

PURPOSE

This study determined the effects of a 2-week step-reduction period followed by 4-week exercise rehabilitation on physical function, body composition, and metabolic health in 70-80-year-olds asymptomatic for injury/illness.

METHODS

A parallel-group randomized controlled trial (ENDURE-study, NCT04997447) was used, where 66 older adults (79% female) were randomized to either intervention or control group. The intervention group reduced daily steps to < 2000, monitored by accelerometer, for two weeks (Period I) and then step-reduction requirement was removed with an additional exercise rehabilitation 4 times per week for 4 weeks (Period II). The control group continued their habitual physical activity throughout with no additional exercise intervention. Laboratory tests were performed at baseline, after Period I and Period II. The primary outcome measure was leg lean mass (LLM). Secondary outcomes included total lean and fat mass, blood glucose and insulin concentration, LDL cholesterol and HDL cholesterol concentration, maximal isometric leg press force (MVC), and chair rise and stair climb performance.

RESULTS

LLM remained unchanged in both groups and no changes occurred in physical function nor body composition in the intervention group in Period I. HDL cholesterol concentration reduced after Period I (from 1.62 ± 0.37 to 1.55 ± 0.36 mmol·L-1, P = 0.017) and returned to baseline after Period II (1.66 ± 0.38 mmol·L-1) in the intervention group (Time × Group interaction: P = 0.065). MVC improved after Period II only (Time × Group interaction: P = 0.009, Δ% = 15%, P < 0.001).

CONCLUSION

Short-term step-reduction in healthy older adults may not be as detrimental to health or physical function as currently thought.

Exercise instructors are not consistently implementing the strength component of the UK chief medical officers' physical activity guidelines in their exercise prescription for older adults

Strength training recommendations have been embedded within the UK's Chief Medical Officers' physical activity guidelines since 2011. There is limited evidence that these recommendations are used by exercise instructors in the community to underpin strength training prescription in the older adult population. This study aimed to explore exercise instructors' awareness and utilisation of the guidelines when prescribing strength training to older adults. Fifteen exercise instructors working with older adults in the UK participated in one online interview. A general inductive approach was conducted and thematic analysis allowed for major themes to be identified from the raw data. We found that most exercise instructors (n = 9), but not all (n = 6), were aware of the guidelines. Only one instructor (n = 1) had reportedly implemented the guidelines into their practice; other instructors reported that the guidelines were irrelevant. Instead, each of the instructors had their preferred sources of information that they relied on to underpin their exercise prescription, and each had their own interpretation of 'evidence-based strength training.' This individualised interpretation resulted in exceptionally varied prescription in the community and does not necessarily align with the progressive, evidence-based prescription known to build muscular strength. We suggest that (i) more detail on how to build muscular strength be embedded within the guidelines, (ii) a handbook on how to implement the guidelines be made available, (iii) theoretical and practical teaching materials and courses be updated, and/or (iv) a re-(education) of exercise instructors already in the field may be necessary to bring about a consistent, evidence-based strength prescription necessary for the best possible health and longevity outcomes for our ageing population.

Resistance Exercise in People With Stage-3 Chronic Kidney Disease: Effects of Training Frequency (Weekly Volume) on Measures of Muscle Wasting and Function

Background: Resistance training (RT) is a proven anabolic intervention in people living with and without chronic kidney disease (CKD). To date, there is a dearth of knowledge regarding the dose-response relationship of RT in the non-dialysis dependent CKD population. Therefore, we aimed to explore the effects of RT frequency (weekly volume) on established measures of muscle wasting and function in CKD.

Methods: Twenty people with stage-3 CKD (CKD-3) were allocated to either a low frequency (one-session per week, RT1) or higher frequency (three-sessions per week, RT3) 12-week RT programme consisting of lower extremity strengthening exercises. The two RT programmes were not volume matched. Assessment outcomes before and after the intervention included measures of total and regional body composition, muscle size and architecture, strength, physical function, and uraemic symptoms.

Results: Significant improvements over time in muscle size and architecture, strength, physical function, and uraemic symptoms were observed for both RT1 and RT3. Compared to RT1, participants who performed RT3 showed greater increases in vastus lateralis (VL) anatomical cross-sectional area (30.8% vs. 13.2%, p < 0.001) and pennation angle (36.3% vs. 17.5%, p = 0.008) after 12 weeks. In either group, there were no significant changes over time in mid-VL fascicle length, nor in measures of total body composition and upper arm muscle strength.

Conclusion: Despite the group differences observed in the VL physiological adaptations, the strength and physical function responses, as well as the reductions of uraemic symptoms, were similar whether training once or thrice weekly. Therefore, performing RT just once per week may be an effective pre-habilitation strategy for people with CKD-3.

Concurrent Training Increases Serum Brain-Derived Neurotrophic Factor in Older Adults Regardless of the Exercise Frequency

Background

Human brain function declines with aging. In this sense, exercise-based interventions has a promising effect on brain plasticity for older adults. Serum brain-derived neurotrophic factor (BDNF) is a positive biomarker for brain neuroplasticity in healthy older adults also modified by exercise training. Selected features of the exercise prescription for improving brain health are missing; therefore, the aim of this study was to determine the effects of concurrent exercise training frequency on serum BDNF levels in healthy older adults.

Methods

Nineteen volunteers (age: 65 ± 4 year; body mass index: 28.0 ± 4.5 kg/m²) completed either a three times/week (3-t/w) (n = 8) or five times/week (5-t/w) (n = 11) concurrent exercise program. The exercise program lasted 11 weeks and all exercise sessions were performed for 50 min at moderate intensity. Serum BDNF, body composition, cardiovascular, and physical fitness variables were assessed before and after the exercise training program.

Results

Regardless of the group, the serum BDNF increased following the intervention (p < 0.001), and there were no significant group (p = 0.827) or interaction (p = 0.063) effects. The maximal oxygen consumption (VO2max) increased regardless of the group (p = 0.007), with a non-significant group (p = 0.722) or interaction (p = 0.223) effects. Upper- and lower-body strength increased in both groups (p = 0.003); however, there was no effect of the training frequency (p = 0.53). For the skeletal muscle mass, there was a trend in the interaction effect (p = 0.053). Finally, the body fat percentage was unchanged.

Conclusion

Eleven weeks of combined exercise training increased serum BDNF levels in healthy older adults, a response independent of the training frequency. The overall fitness level improved similarly in both exercise groups. These data reveal that a minimal dosage of concurrent exercise enhance functional capacity and a brain health biomarker in older adults.

Evidence-based recommendations for resistance and power training to prevent frailty in community-dwellers

Frailty is a reversible state of reduced resilience to stressful events resulting from a multisystem impairment of the human body. As frailty progresses, people become more vulnerable to numerous adverse events, including falls and fractures, cognitive decline, disability, hospitalization, nursing home placement, and death. As such, substantial health care costs are associated with frailty. These features have led to the recognition of frailty as a public health problem. The identification of strategies for the management of frailty has, therefore, become a topic of extensive instigation. In this context, resistance (RT) and power training (PT) have received considerable attention, and experts in the field have recently suggested that both training modalities may improve frailty-related parameters. However, most studies have only included robust people and investigated frailty as a secondary outcome, so that current literature only allows RT and PT preventive programs against frailty to be designed. Here, we provide evidence-based critical recommendations for the prescription of RT and PT programs against incident frailty in community-dwellers.

The Effect of a Mixed Circuit of Aerobic and Resistance Training on Body Composition in Older Adults-Retrospective Study

Ageing is inevitably associated with body composition changes, such as loss of muscle mass, increase in the total fat mass, and unfavorable reduction of subcutaneous fat. Physical activity exerts significant effects on the body composition. The aim of the study was to investigate the effects of two different weekly doses of resistance-aerobic training on the body composition in older people. The study consisted in a retrospective data analysis of fitness club members aged ≥60. The trainees participated in resistance-aerobic training sessions two or three times/week for a minimum of two months. A body composition analysis was performed before and after the training sessions. Group 1 (36 subjects) and Group 2 (28 subjects) had two and three training sessions/week, respectively. A higher skeletal muscle mass was found in Group 1 and lower waist-hip-ratio indices were observed in Group 2. No statistically significant differences were found in the body mass, skeletal muscle mass, fat mass, total body water, lean mass, body mass index, visceral fat area between both groups. The number of training session/week proved to be statistically insignificant for all investigated variables. Resistance-aerobic training with two sessions/week may be as effective in maintaining proper body composition in older people as the same training at the dose of three sessions/week.

Validity and reliability of the motivation for physical activity (RM4-FM) questionnaire

There is a lack of validated instruments measuring motivation for physical activity (RM4-FM) in the Finnish language. The study examined the translated RM4-FM instrument's psychometric properties in a sample of healthy, older Finnish adults. RM4-FM was translated and linguistically validated adhering to published guidelines. 65-75-year olds (n=102), completed the RM4-FM, the physical activity acceptance questionnaire (PAAQ) and sociodemographic characteristics questionnaires electronically. The RM4-FM was readministered one month after the initial assessment. RM4-FM translated well into Finnish. Motivation dimension scores were skewed towards high internal and low external motivation. A floor effect was confirmed in the external regulation dimension and a ceiling effect was confirmed in the identified regulation dimension. Confirmatory factor analysis indicated inadequacy of the four-dimension model. Separate assessment of each of the four motivation dimensions with Exploratory factor analysis showed unidimensionality for all dimensions. Exploratory factor analysis provided a best-fit model of three factors (influence of other people, intention of well-being and emotional aspect of motivation). Readministration of the instruments showed good test-retest reliability in all motivation dimensions. Female gender, higher education, and higher PAAQ score were associated with higher internal motivation and lower external motivation scores. The Finnish version of the RM4-FM instrument provides valid and reliable scores in assessing motivation for physical activity in healthy, older Finnish adults. The score distributions suggested shortages in the scale when evaluating internal motivation. The three-factor model of the RM4-FM provided more favorable structural validity compared to the original version.

Heavy resistance training in the management of hip pain in older adults: A case series

Background and Purpose: Resistance training has been shown to improve strength, endurance, and function in healthy older adults. The purpose of this case series was to describe the outcomes of a rehabilitation program consisting of heavy resistance training in older adults for management of hip pain. Case Description: Two male patients, aged 69 and 71, with chronic hip pain, participated in a six-week progressive resistance training rehabilitation program at loads equivalent to 76-81% of their one repetition maximum. Outcomes were assessed at evaluation, three, and six weeks. Outcomes included the Lower Extremity Functional Scale, hip and lumbar mobility, and the Five Times Sit to Stand test. Outcomes: By six weeks, each patient reported 0/10 pain and demonstrated clinically important improvements on the LEFS. Both patients' final scores on the Five Times Sit to Stand test fell below the 15 second value for being at risk for falls. Patient One increased his lifting capacity for the deadlift by 92%, and Patient Two by 56%. Both patients were able to deadlift >70% of their one repetition maximum by the conclusion of this report. Discussion: To our knowledge, this is the first report of the outcomes of utilizing heavy resistance training in elderly adults with hip pain in a rehabilitative setting. Both patients demonstrated clinically important improvements in pain, disability, global lower extremity strength, and function by the conclusion of six weeks duration. Further research is needed regarding the effectiveness of heavy resistance training for the treatment of elderly adults with musculoskeletal pain.

The effect of daily protein supplementation, with or without resistance training for 1 year, on muscle size, strength, and function in healthy older adults: A randomized controlled trial

BACKGROUND

Protein supplementation alone or combined with resistance training has been proposed to be effective in counteracting age-related losses of muscle mass and strength.

OBJECTIVES

To investigate the effect of protein supplementation alone or combined with light-intensity or heavy-load resistance exercise on muscle size, strength, and function in older adults.

METHODS

In a 1-y randomized controlled trial, 208 healthy older adults (>65 y) were randomly assigned to 1 of 5 interventions: 1) carbohydrate supplementation (CARB); 2) collagen protein supplementation (COLL); 3) whey protein supplementation (WHEY); 4) light-intensity resistance training 3-5 times/wk with whey protein supplementation (LITW); and 5) heavy resistance training 3 times weekly with whey protein supplementation (HRTW). Protein supplements contained 20 g protein + 10 g carbohydrate, whereas CARB contained 30 g of carbohydrates. All intervention groups received the supplement twice daily. The primary outcome was change in the quadriceps cross-sectional area (qCSA). Secondary outcomes included measures of lower extremity strength and power, functional capabilities, and body composition.

RESULTS

There were 184 participants who completed the study. COLL and WHEY did not affect any measured parameter compared to CARB. Compared to WHEY, HRTW improved the qCSA size (between-group difference, +1.68 cm2; 95% CI, +0.41 to +2.95 cm2; P = 0.03), as well as dynamic (+18.4 Nm; 95% CI, +10.1 to +26.6 Nm; P < 10-4) and isometric knee extensor strength (+23.9 Nm; 95% CI, +14.2 to +33.6 Nm; P < 10-5). LITW did not improve the qCSA size, but increased dynamic knee extensor strength compared to WHEY (+13.7 Nm; 95% CI, +5.3 and +22.1 Nm; P = 0.01).

CONCLUSIONS

Recommending protein supplementation as a stand-alone intervention for healthy older individuals seems ineffective in improving muscle mass and strength. Only HRTW was effective in both preserving muscle mass and increasing strength. Thus, we recommend that future studies investigate strategies to increase long-term compliance to heavy resistance exercise in healthy older adults. This trial was registered at clinicaltrials.gov as NCT02034760.

Ultrasonographic Size of the Thenar Muscles of the Nondominant Hand Correlates with Total Body Lean Mass in Healthy Subjects

RATIONALE AND OBJECTIVES

Sarcopenia is associated with adverse outcomes in clinical situations such as elderly population, in-hospital setting and oncologic patients. However, no direct measurement of muscular mass is routinely available for clinicians. The aim of this study was to assess the correlation between thenar musculature of the nondominant hand evaluated by ultrasound and body fat-free mass.

MATERIALS AND METHODS

In this one-center, cross-sectional, observational study, the width and depth of thenar muscles of both hands was assessed by ultrasonography. Nondominant hand musculature was taken as reference as a better estimator of total body muscular mass. These data were compared to body composition by bioimpedance analysis and dual-energy X-ray absorptiometry (DXA), hand grip strength, arm muscular area and physical activity (with International Physical Activity Questionnaire ). Statistical correlation was determined for each parameter.

RESULTS

We obtained ultrasonographic measurements, International Physical Activity Questionnaire and hand grip strength from 83 subjects, whereas bioimpedance was performed in 64 subjects and DXA in 29 subjects. The strongest correlations were found between longitudinal thenar depth vs fat-free mass index (fat-free mass in DXA [kg]/height² [m]) (r = 0.63, p < 0.001, 95%CI 0.34-0.81), longitudinal depth and hand dynamometry (r = 0.72, p < 0.001, 95%CI 0.59-0.81), longitudinal depth and DXA fat-free total mass (r = 0.76, p < 0.001, 95%CI 0.54-0.88), transversal thenar depth vs fat-free mass index (r = 0.67, p < 0.001, 95%CI 0.41-0.83), transversal width and DXA fat-free total mass (r = 0.62, p < 0.001, 95%CI 0.33-0.8), transversal depth and DXA nonfat total mass (r = 0.81, p < 0.001, 95%CI 0.63-0.91).

CONCLUSION

Ultrasonographic examination of the nondominant thenar musculature is a fast and simple way of assessing total body fat-free mass, showing a good correlation with body composition measured by bioimpedance analysis and DXA, hand grip strength and arm muscular area.

Skeletal Muscle Adaptations Following 80 Weeks of Resistance Exercise in Older Adults

BACKGROUND AND PURPOSE

We followed and documented skeletal muscle adaptations from 4 resistance exercise (RE) prescriptions in older adults over the course of a 2-year, 80-week training study.

METHODS

Forty-three older men and women-65.2 (3.5) years, 167.2 (7.5) cm, and 72.5 (14.7) kg-completed one of the following RE prescriptions: high-load 2 days per week (HL2D; n = 12), low-load 2 days per week (LL2D; n = 9), high-load 3 days per week (HL3D, n = 12), or low-load 3 days per week (LL3D, n = 10). High-load prescriptions consisted of 3 sets of 8 repetitions with 80% 1-repetition maximum (1-RM) and low-load prescriptions completed 3 sets of 16 repetitions with 40% 1-RM. Each session consisted of 12 exercises targeting major muscle groups and training loads were adjusted every fifth week to maintain progressive overload. Participants completed 40 weeks of supervised training, had a 2-month break, and then resumed another 40 weeks of supervised training. Bone-free lean body mass (BFLBM) and appendicular lean mass (ALM) were assessed via dual-energy x-ray absorptiometry and muscle cross-sectional area (mCSA) of the rectus femoris with diagnostic ultrasound across the intervention.

RESULTS AND DISCUSSION

Groups responded similarly with significant increases in total strength (54.9%), upper body strength (42.7%), lower body strength (61.5%), and specific strength (50.3%, strength/BFLBM) over 80 weeks (all P < .001). Significant increases for BFLBM (3.0%), ALM (3.5%), and mCSA (48.7%) were also observed (all P ≤ .019). The only difference among groups indicated HL3D displaying significantly greater percent increase than LL2D for ALM (P = .043).

CONCLUSIONS

Resistance exercise performed 2 or 3 days per week with moderate to heavy loads can improve muscle strength and induce small but perhaps clinically significant increases in BFLBM and mCSA in older adults over a 2-year period of supervised training.

Effects of Different Weekly Sets-Equated Resistance Training Frequencies on Muscular Strength, Muscle Mass, and Body Fat in Older Women

Pina, FLC, Nunes, JP, Schoenfeld, BJ, Nascimento, MA, Gerage, AM, Januário, RSB, Carneiro, NH, Cyrino, ES, and Oliveira, AR. Effects of different weekly sets-equated resistance training frequencies on muscular strength, muscle mass and body fat in older women. J Strength Cond Res 34(10): 2990-2995, 2020-The aim of this study was to analyze the effects of different resistance training (RT) frequencies (2 vs. 3 times per week) with an equivalent number of weekly sets performed between conditions on muscular strength and body composition in older women. Forty-seven older women (65 ± 4 years) were divided into 2 groups that performed a 12-week RT program either 2 (G2x and 3 sets) or 3 (G3x and 2 sets) times per week. The groups were evaluated before and after study on measures of body composition through dual-energy x-ray absorptiometry, and muscular strength through one repetition maximum (1RM) testing. Lean soft tissue was significantly increased in both groups (G2x = +1.7%, G3x = +1.7%), while only G3x reduced body fat after the intervention period (G2x = -0.7%, G3x = -2.9%). Similarly, significant increases were noted between conditions for 1RM scores in bench press (G2x = +11.8%, G3x = +11.9%) and knee extension (G2x = +17.4%, G3x = +10.8%). The results indicate that performing 2 or 3 RT sessions per week promotes similar improvements in muscular outcomes, while training more frequently may reduce body fat after 12 weeks of weekly sets-equated RT in untrained older women.

Immediate Effects of Aquatic Therapy on Balance in Older Adults with Upper Limb Dysfunction: An Exploratory Study

Background: Aquatic physiotherapy has been shown to be effective in developing balance, strength, and functional reach over time. When dealing with immediate effects, the literature has concentrated more on the body’s physiological response to the physical and mechanical properties of water during passive immersion. The purpose of this study was to evaluate the effects of a single 45-min active aquatic physiotherapy session on standing balance and strength, and its relationship with functional reach in persons 55 years and older with upper limb dysfunction. Methods: The intervention group (n = 12) was assessed before and after a single aquatic physiotherapy session, while the control group (n = 10) was evaluated before and after 45 min of sitting rest. Functional assessment was made using the visual analogue pain scale (points), step test (repetitions), functional reach test (cm), and global balance-standing test on a force platform (% time). A two-way repeated-measures ANOVA was applied (p < 0.05). Results: The intervention group showed non-significant improvements between measurement before and after the intervention: Pain: 6.2 ± 1.9 vs. 5.2 ± 2.3 cm, steps: 7.0 ± 2.0 vs. 7.4 ± 1.8 repetitions, reach: 9.1 ± 2.8 vs. 10.4 ± 3.8 cm, and balance: 61.7 ± 5.9 vs. 71.3 ± 18.2% time in balance on the platform. The control group showed fewer changes but had better baseline values. A comparison between groups with time showed no significant differences in these changes. Conclusions: No significant immediate effects were found for one session of aquatic physiotherapy applied to patients older than 55 years with upper limb dysfunction.

Do All Resistance Exercise Protocols Improve the Functional Parameters of the Elderly? A Review Study

Context: Aging has been associated with negative changes in the neuromuscular system, significantly impairing the performance of daily life activities. A number of studies have validated functional tests (e.g. timed-up-and-go, gait speed) for the assessment of daily activity performance in the elderly. Thus, it is critical to understand the role of exercise training in this context. The practice of resistance training (RT) has been found to promote muscle strength in the elderly; however, we cannot safely state that any of these resistance exercise protocols would lead to improved performance of functional parameters (e.g. timed-up-and-go, gait speed, getting out of a chair) of this population. To assess the effects of RT on functional parameters of the elderly and to undertake a detailed assessment of the exercise protocols surveyed. Methods: PubMed, Cochrane CENTRAL, and PEDro databases were used to search the literature. A total of 917 articles were initially selected, of which 10 peer-reviewed articles met the search criteria. Results: In the included studies, the positive effects of RT on the functional parameters of the elderly were observed. The training protocols presented the following characteristics: duration of 12 – 16 - 24 - 36 - 60 - 72 sec and 96 sessions; frequency of 1 - 3 sessions per week; training volume of 2 - 5 sets of 4 - 15 repetitions; 40 - 60 - 90 - 120 - 180 sec rest interval between sets; 40 - 60 - 90 - 120 - 180 sec rest interval between exercises; 24 - 48 - 72 hour rest interval between sessions; 40 - 85% intensity of one maximum repetition; isotonic contractions, contraction velocity (as fast as possible-1 - 2 - 3 seconds to concentric and 2 - 3 seconds to eccentric phases). Conclusions: Although the benefits of RT were observed, it was not possible to determine that any of these resistance exercise protocols would lead to improved performance of functional parameters (e.g. timed-up-and-go, gait speed, getting out of a chair) of this population, given the limitations we found in the research papers reviewed.

The influence of sex, training intensity, and frequency on muscular adaptations to 40 weeks of resistance exercise in older adults

The purpose of this investigation was to identify the influence that sex, training intensity, and frequency have on long-term resistance exercise (RE) outcomes in older adults.

METHODS

One-hundred eleven older adults (men: 41, women: 70) completed either: high-intensity RE 2d/week (HI-2D; n = 29), low-intensity RE 2d/week (LI-2D; n = 32), high-intensity RE 3d/week (HI-3D, n = 20), or low-intensity RE 3d/week (LI-3D, n = 30). HI protocols completed 3 sets of 8 repetitions with 80% one-repetition maximum (1-RM) while LI completed 3 sets of 16 repetitions with 40% 1-RM. Total and regional bone free lean body mass (BFLBM) were assessed via dual-energy x-ray absorptiometry and cross-sectional area (mCSA) of the rectus femoris.

RESULTS

mCSA was the only muscle quantity parameter to increase (p = 0.043). Significant trial effects for upper body, lower body, and specific strength were observed (all p < 0.001). Significant sex × time interactions (p < 0.001) were observed for upper and lower body strength, however, men and women displayed similar increases in lower body (45.7 ± 29.6 vs 46.4 ± 34.9%), upper body (33.1 ± 21.0 vs 33.4 ± 24.7%), and specific strength (36.5 ± 28.5 vs 40.1 ± 28.7%). A group × time interaction for lower body strength indicated that at 20-weeks HI-2D and LI-3D displayed greater lower body strength than LI-2D (both p < 0.009), and at 40-weeks HI-2D, HI-3D, and LI-3D displayed significantly greater lower body strength than LI-2D (all p < 0.038).

CONCLUSIONS

These observations indicate that older men and women display similar long-term RE outcomes. Additionally, regardless of frequency or intensity, the current prescriptions were effective for increasing strength, however these data suggest HI-2D > LI-2D and LI-3D > LI-2D but similar outcomes among HI-2D, HI-3D, and LI-3D. The variety of effective RE approaches provides flexibility among older adults for selecting a lifestyle intervention that would be most sustainable.

Health-promoting and preventive interventions for community-dwelling older people published from inception to 2019: a scoping review to guide decision making in a Swedish municipality context

Background

Despite the promising evidence of health-promoting and preventive interventions for maintaining health among older people, not all interventions can be implemented due to limited resources. Due to the variation of content in the interventions and the breadth of outcomes used to evaluate effects in such interventions, comparisons are difficult and the choice of which interventions to implement is challenging. Therefore, more information, beyond effects, is needed to guide decision-makers. The aim of this review was to investigate, to what degree factors important for decision-making have been reported in the existing health-promoting and preventive interventions literature for community-dwelling older people in the Nordic countries.

Methods

This review was guided by the PRISMA-ScR checklist (Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews), the methodological steps for scoping reviews described in the Arksey and O′Malley’s framework, and the Medical Research Council’s (MRC) guidance on complex interventions. Eligible studies for inclusion were randomised controlled trials (RCTs) concerning health promotion or primary prevention for community-dwelling older people implemented in the Nordic countries. Additionally, all included RCTs were searched for related papers that were reporting on additional factors. Eligible studies were searched in seven databases: PubMed, SCOPUS, CINAHL, Academic Search Elite, PsycINFO, SocINDEX, and SPORTDiscus.

Results

Eighty-two studies met the inclusion criteria (twenty-seven unique studies and fifty-five related studies). Twelve studies focused on fall prevention, eleven had a health-promoting approach, and four studies focused on preventing disability. All interventions, besides one, reported positive effects on at least one health outcome. Three studies reported data on cost-effectiveness, three on experiences of participants and two conducted feasibility studies. Only one intervention, reported information on all seven factors.

Conclusions

All identified studies on health-promoting and preventive interventions for older people evaluated in the Nordic countries report positive effects although the magnitude of effects and number of follow-ups differed substantially. Overall, there was a general lack of studies on feasibility, cost-effectiveness, and experiences of participants, thus, limiting the basis for decision making. Considering all reported factors, promising candidates to be recommended for implementation in a Nordic municipality context are ‘Senior meetings’, ‘preventive home visits’ and ‘exercise interventions’ on its own or combined with other components.

A meta-regression of the effects of resistance training frequency on muscular strength and hypertrophy in adults over 60 years of age

Resistance training is a commonly used strategy for improving both athletic performance and general health. While the contribution of resistance training intensity and volume to muscle strength and hypertrophy have been extensively investigated, training frequency only recently received sufficient attention, especially in older adults. A meta-regression was conducted to compare muscle strength and hypertrophic adaptations to resistance training programmes performed with different training frequencies in adults over 60 years of age. The systematic literature search identified 14 articles for meta-regression. For each outcome, an effect size (ES) was calculated as the pre-test-post-test change, divided by the pooled pre-test standard deviation (SD). Random-effects meta-regressions for multilevel data structures, using study as the clustering variable, were performed using package metafor in R. Maximal strength shows a significant effect of frequency (p = 0.001), with an increase in effect size of 0.14 for every day increase in frequency (CI: 0.08, 0.21). For muscle hypertrophy, no significant effect of frequency was found (p = 0.67). Considering that muscle hypertrophy was not affected, while maximum strength was only slightly improved with additional training days, it seems unlikely that more than two weekly resistance training sessions would provide any further benefits for older adults.

Supervised Physical Training Enhances Muscle Strength but Not Muscle Mass in Prostate Cancer Patients Undergoing Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis

Introduction: Androgen deprivation therapy (ADT) is considered the basic treatment for advanced prostate cancer, but it is highly associated with detrimental changes in muscle mass and muscle strength. The aim of this meta-analysis was to investigate the effects of supervised physical training on lean mass and muscle strength in prostate cancer patients undergoing ADT.

Methods: A systematic literature search was performed using MEDLINE, Embase, and ScienceDirect until October 2018. Only studies that examined both muscle mass and strength in prostate cancer patients undergoing ADT were included. Outcomes of interest were changes in lean body mass (surrogate for muscle mass) as well as upper and lower body muscle strength. The meta-analysis was performed with fixed-effects models to calculate mean differences between intervention and no-training control groups.

Results: We identified 8,521 publications through the search of the following key words: prostate cancer, prostate tumor, prostate carcinoma, prostate neoplasm, exercise, and training. Out of these studies, seven randomized controlled trials met the inclusion criteria and where included in the analysis. No significant mean differences for changes in lean mass were observed between the intervention and control groups (0.49 kg, 95% CI: −0.76, 1.74; P = 0.44). In contrast, the mean difference for muscle strength was significant both in chest (3.15 kg, 95% CI: 2.46, 3.83; P < 0.001) and in leg press (27.46 kg, 95% CI: 15.05, 39.87; p < 0.001).

Conclusion: This meta-analysis provides evidence that low- to moderate-intensity resistance and aerobic training is effective for increasing muscle strength but may not be sufficient to affect muscle mass in prostate cancer patients undergoing ADT. The underlying mechanisms for this maladaptation may in part be explained by an insufficient stimulus induced by the training regimens as well as a delayed initiation of training in relation to the start of ADT. When interpreting the present findings, one should bear in mind that the overall number of studies included in this review was rather low, emphasizing the need for further studies in this field.

Strength Training Improves Metabolic Health Markers in Older Individual Regardless of Training Frequency

The main purpose of the present study was to investigate the effect of frequency, thereby increasing training volume, of resistance training on body composition, inflammation markers, lipid and glycemic profile in healthy older individuals (age range 65–75 year). Ninety-two healthy participants were randomly assigned to one of four groups; performing strength training one- (EX1), two- (EX2), or three- (EX3) times-per-week and a non-training control (CON) group. Whole-body strength training was performed using 2–5 sets and 4–12 repetitions per exercise and 7–9 exercises per session. All training groups attended supervised resistance training for 6 months. Body composition was measured by dual X-ray absorptiometry and fasting blood samples were taken pre- and post-training. There were significant main effects of time for total fat mass (F = 28.12, P < 0.001) and abdominal fat mass (F = 20.72, P < 0.001). Pre- to post-study, statistically significant reductions in fat mass (Δ = -1.3 ± 1.4 kg, P < 0.001, n = 26) were observed in EX3. Pre- to post-study reductions in low density lipoprotein (LDL) concentration (Δ = -0.38 ± 0.44 mmol⋅L^-1, P = 0.003, n = 19) were observed only in EX3, whereas a significant pre- to post-study increases in high density lipoprotein (HDL) concentration (0.14–0.19 mmol⋅L^-1) were observed in all training groups. Most variables at baseline demonstrated a significant (negative) relationship when correlating baseline values with their change during the study including: Interleukin-6 (IL-6) (r = -0.583, P < 0.001), high-sensitivity c-reactive protein (hs-CRP) (r = -0.471, P < 0.001, and systolic blood pressure (r = -0.402, P = 0.003). The present study suggests that having more than two resistance training sessions in a week could be of benefit in the management of body composition and lipid profile. Nevertheless, interestingly, and importantly, those individuals with a higher baseline in systolic blood pressure, IL-6 and hs-CRP derived greatest benefit from the resistance training intervention, regardless of how many times-a-week they trained. Finally, the present study found no evidence that higher training frequency would induce greater benefit regarding inflammation markers or glycemic profile in healthy older adults.

Exercise-induced hypoalgesia: A meta-analysis of exercise dosing for the treatment of chronic pain

OBJECTIVE

Increasing evidence purports exercise as a first-line therapeutic for the treatment of nearly all forms of chronic pain. However, knowledge of efficacious dosing respective to treatment modality and pain condition is virtually absent in the literature. The purpose of this analysis was to calculate the extent to which exercise treatment shows dose-dependent effects similar to what is seen with pharmacological treatments.

METHODS

A recently published comprehensive review of exercise and physical activity for chronic pain in adults was identified in May 2017. This report reviewed different physical activity and exercise interventions and their effectiveness in reducing pain severity and found overall modest effects of exercise in the treatment of pain. We analyzed this existing data set, focusing specifically on the dose of exercise intervention in these studies. We re-analyzed data from 75 studies looking at benefits of time of exercising per week, frequency of exercise per week, duration of intervention (in weeks), and estimated intensity of exercise.

RESULTS

Analysis revealed a significant positive correlation with exercise duration and analgesic effect on neck pain. Multiple linear regression modeling of these data predicted that increasing the frequency of exercise sessions per week is most likely to have a positive effect on chronic pain patients.

DISCUSSION

Modest effects were observed with one significant correlation between duration and pain effect for neck pain. Overall, these results provide insufficient evidence to conclude the presence of a strong dose effect of exercise in pain, but our modeling data provide tes predictions that can be used to design future studies to explicitly test the question of dose in specific patient populations.

How many times per week should a muscle be trained to maximize muscle hypertrophy? A systematic review and meta-analysis of studies examining the effects of resistance training frequency

Training frequency is considered an important variable in the hypertrophic response to regimented resistance exercise. The purpose of this paper was to conduct a systematic review and meta-analysis of experimental studies designed to investigate the effects of weekly training frequency on hypertrophic adaptations. Following a systematic search of PubMed/MEDLINE, Scoups, and SPORTDiscus databases, a total of 25 studies were deemed to meet inclusion criteria. Results showed no significant difference between higher and lower frequency on a volume-equated basis. Moreover, no significant differences were seen between frequencies of training across all categories when taking into account direct measures of growth, in those considered resistance-trained, and when segmenting into training for the upper body and lower body. Meta-regression analysis of non-volume-equated studies showed a significant effect favoring higher frequencies, although the overall difference in magnitude of effect between frequencies of 1 and 3+ days per week was modest. In conclusion, there is strong evidence that resistance training frequency does not significantly or meaningfully impact muscle hypertrophy when volume is equated. Thus, for a given training volume, individuals can choose a weekly frequency per muscle groups based on personal preference.

Strength training is associated with better functional fitness and perceived healthy aging among physically active older adults: a cross-sectional analysis of the Canadian Longitudinal Study on Aging

BACKGROUND

Regular participation in strength exercise is important to promote healthy aging. However, much of the available evidence on physical activity and older adults has focused on aerobic activity, while there is less research on the benefits of exercise that is performed specifically to strengthen muscles.

AIMS

Using cross-sectional data from the Canadian Longitudinal Study on Aging, the purpose of this study was to determine if strength training is associated with better functional fitness and health among older adults who meet the minimum guidelines for aerobic physical activity.

METHODS

Older adults who met guidelines for aerobic physical activity (≥ 60 years, N = 9100) completed performance-based assessments of physical function and self-reported their physical activity, perceived health, and chronic conditions. Body fat was determined using DEXA. Logistic regression analyses were used to determine whether strength training was associated with better functional fitness, body composition, and health.

RESULTS

32.5% of active older adults reported engaging in strength training 1-7 days per week. Participating in any strength training was associated with better scores on measures of balance (OR 1.17, CI 1.04, 1.32), mobility (OR 1.32, CI 1.18, 1.47), body fatness (OR 1.58, CI 1.38, 1.81), and better perceived health (OR 1.34, CI 1.19, 1.51), and healthy aging (OR 1.26, CI 1.12, 1.42).

DISCUSSION

These results suggest that all older adults, even those who are active and have good mobility, may benefit from strength training.

CONCLUSION

Physical activity guidelines should place a greater emphasis on strength training for older adults.

Resistance training frequency and skeletal muscle hypertrophy: A review of available evidence

OBJECTIVES

Current reviews and position stands on resistance training (RT) frequency and associated muscular hypertrophy are based on limited evidence holding implications for practical application and program design. Considering that several recent studies have shed new light on this topic, the present paper aimed to collate the available evidence on RT frequency and the associated effect on muscular hypertrophy.

DESIGN

Review article.

METHODS

Articles for this review were obtained through searches of PubMed/MEDLINE, Scopus, and SPORTDiscus. Both volume-equated (studies in which RT frequency is the only manipulated variable) and non-volume-equated (studies in which both RT frequency and volume are the manipulated variables) study designs were considered.

RESULTS

Ten studies were found that used direct site-specific measures of hypertrophy, and, in general, reported that RT once per week elicits similar hypertrophy compared to training two or three times per week. In addition, 21 studies compared different RT frequencies and used lean body mass devices to estimate muscular growth; most of which reported no significant differences between training frequencies. Five studies were identified that used circumference for estimating muscular growth. These studies provided findings that are difficult to interpret, considering that circumference is a crude measure of hypertrophy (i.e., it does not allow for the differentiation between adipose tissue, intracellular fluids, and muscle mass).

CONCLUSIONS

Based on the results of this review, it appears that under volume-equated conditions, RT frequency does not seem to have a pronounced effect of gains in muscle mass.

Effect of resistance training with different frequencies and subsequent detraining on muscle mass and appendicular lean soft tissue, IGF-1, and testosterone in older women

OBJECTIVE

To analyse the effect of resistance training (RT) frequency on muscle mass, appendicular lean soft tissue, insulin-like growth factor 1 (IGF-1), testosterone, and their changes with detraining in older women.

METHODS

Forty-five physically independent older women (≥ 60 years) were randomly assigned to perform RT either two (G2X, n = 21) or three times/week (G3X, n = 24), during 12 weeks (8 exercises, 1 set of 10-15 repetition maximum). Muscle mass and appendicular lean soft tissue, IGF-1, testosterone, and dietary intake were measured at pre-training, post-training, and after detraining (12 weeks).

RESULTS

Muscle mass and appendicular lean soft tissue significantly increased post-training (G2X = +5.5% and G3X = +5.8%, P < .0001) with no differences between groups, and gains were retained after detraining (G2X = 100% and G3X = 99%, P < .0001). IGF-1 and dietary intake did not change for the groups during the study. Testosterone did not change post-training but significantly decreased after detraining (G2X = -21% and G3X = -50%, P < .0001).

CONCLUSION

We conclude that lower RT frequency is as effective as higher frequency to improve muscle mass and appendicular lean soft tissue, and to maintain testosterone and IGF-1. Additionally, detraining may reduce testosterone regardless of RT frequency. These results are specifically for community-dwelling older women and may not be generalized to other populations.

The effects of 12-week progressive strength training on strength, functional capacity, metabolic biomarkers, and serum hormone concentrations in healthy older women: morning versus evening training

Previous findings suggest that performing strength training (ST) in the evening may provide greater benefit for young individuals. However, this may not be optimal for the older population. The purpose of this study was to compare the effects of a 12-week ST program performed in the morning vs. evening on strength, functional capacity, metabolic biomarker and basal hormone concentrations in older women. Thirty-one healthy older women (66 ± 4 years, 162 ± 4 cm, 75 ± 13 kg) completed the study. Participants trained in the morning (M) (07:30, n = 10), in the evening (E) (18:00, n = 10), or acted as a non-training control group (C) (n = 11). Both intervention groups performed whole-body strength training with 3 sets of 10-12 repetitions with 2-3 minutes rest between sets. All groups were measured before and after the 12-week period with; dynamic leg press and seated-row 6-repetition maximum (6-RM) and functional capacity tests (30-second chair stands and arm curl test, Timed Up and Go), as well as whole-body skeletal muscle mass (SMM) (kg) and fat mass (FM-kg, FM%) assessed by bioelectrical impedance (BIA). Basal blood samples (in the intervention groups only) taken before and after the intervention assessed low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), blood glucose (GLU), triglycerides (TG), high-sensitive C-reactive protein (hsCRP) concentrations and total antioxidant status (TAS) after a 12 h fast. Hormone analysis included prolactin (PRL), progesterone (P) estradiol (ESTR), testosterone (T), follicle stimulating hormone (FSH), and luteinizing hormone (LH). While C showed no changes in any variable, both M and E significantly improved leg press (+ 46 ± 22% and + 21 ± 12%, respectively; p < 0.001) and seated-row (+ 48 ± 21% and + 42 ± 18%, respectively; p < 0.001) 6-RM, as well as all functional capacity outcomes (p < 0.01) due to training. M were the only group to increase muscle mass (+ 3 ± 2%, p < 0.01). Both M and E group significantly (p < 0.05) decreased GLU (-4 ± 6% and -8 ± 10%, respectively), whereas significantly greater decrease was observed in the E compared to the M group (p < 0.05). Only E group significantly decreased TG (-17 ± 25%, p < 0.01), whereas M group increased (+ 15%, p < 0.01). The difference in TG between the groups favored E compared to M group (p < 0.01). These results suggest that short-term "hypertrophic" ST alone mainly improves strength and functional capacity performance, but it influences metabolic and hormonal profile of healthy older women to a lesser extent. In this group of previously untrained older women, time-of-day did not have a major effect on outcome variables, but some evidence suggests that training in the morning may be more beneficial for muscle hypertrophy (i.e. only M significantly increased muscle mass and had larger effect size (M: g = 2 vs. E: g = 0.5).

Motivational characteristics and resistance training in older adults: A randomized controlled trial and 1-year follow-up

The aim of this study was to investigate the effects of a 9-month supervised resistance training intervention on motivational and volitional characteristics related to exercise, and whether the absolute level and/or intervention-induced change in these characteristics predict self-directed continuation of resistance training 1 year after the intervention. Community dwelling older adults aged 65-75, who did not fulfill physical activity recommendations, were randomized into resistance training intervention groups: training once- (n = 26), twice- (n = 27), three-times-a-week (n = 28) or non-training control group (n = 25). Training groups participated in supervised resistance training for 9 months: during months 1-3 all groups trained twice-a-week and then with allocated frequencies during months 4-9. Exercise-related motivation, self-efficacy, and planning were measured with questionnaires at baseline, month-3 and month-9. The continuance of resistance training was determined by interviews 6 and 12 months after the end of the intervention. The intervention improved action and coping planning as well as intrinsic motivation (group × time P < .05). During 1-year follow-up, 54% of participants did not continue self-directed regular resistance training, 22% continued regular resistance training once-a-week, and 24% twice-a-week. Increases in exercise self-efficacy and intrinsic motivation related to training during the intervention predicted continuation of resistance training twice-a-week. Resistance training improved exercise-related motivational and volitional characteristics in older adults. These improvements were linked to continuing resistance training 1 year after the supervised intervention. The role of these characteristics should be taken into account when promoting long-term resistance training participation among older adults.

High-intensity stretch-shortening contraction training modifies responsivity of skeletal muscle in old male rats

Utilization of high-intensity resistance training to counter age-related sarcopenia is currently debated because of the potential for maladaptation when training design is inappropriate. Training design is problematic because the influence of various loading variables (e.g. contraction mode, repetition number, and training frequency) is still not well characterized at old age. To address this in a precisely controlled manner, we developed a rodent model of high-intensity training consisting of maximally-activated stretch-shortening contractions (SSCs), contractions typical during resistance training. With this model, we determined that at old age, high-repetition SSC training (80 SSCs: 8 sets of 10 repetitions) performed frequently (i.e. 3 days per week) for 4.5 weeks induced strength deficits with no muscle mass gain while decreasing frequency to 2 days per week promoted increases in muscle mass and muscle quality (i.e. performance normalized to muscle mass). This finding confirmed the popular notion that decreasing training frequency has a robust effect with age. Meanwhile, the influence of other loading variables remains contentious. The aim of the present study was to assess muscle adaptation following modulation of contraction mode and repetition number during high-intensity SSC training. Muscles of young (3 month old) and old (30 month old) male rats were exposed to 4.5 weeks of low-repetition static training of 4 (i.e. 4 sets of one repetition) isometric (ISO) contractions 3 days per week or a more moderate-repetition dynamic training of 40 SSCs (i.e. 4 sets of 10 repetitions) 3 days per week. For young rats, performance and muscle mass increased regardless of training protocol. For old rats, no muscle mass adaptation was observed for 4 ISO training while 40 SSC training induced muscle mass gain without improvement in muscle quality, an outcome distinct from modulating training frequency. Muscle mass gain for old rats was accompanied by decreased protein levels of tumor necrosis factor alpha, a mediator of age-related chronic inflammatory signaling, to young levels. These findings suggest that while dynamic high-intensity training with a moderate number of repetitions has a limited capacity for altering muscle quality, such training is a viable strategy for countering age-related inflammatory signaling and modifying muscle mass.

Effects of a 9-month resistance training intervention on quality of life, sense of coherence, and depressive symptoms in older adults: randomized controlled trial

Purpose

(1) To determine the effects of a 9-month resistance training intervention on quality of life, sense of coherence, and depressive symptoms in older adults, and (2) to compare effects between different training frequencies.

Methods

Men and women aged 65–75 (N = 106) were randomized to four groups according to training frequency: training groups RT1 (n = 26), RT2 (n = 27), and RT3 (n = 28) and non-training control group (n = 25). All training groups attended supervised resistance training twice a week for 3 months. For the following 6 months, they continued training with different frequencies (1, 2 or 3 times per week). Psychological functioning was measured by quality of life (WHOQOL-Bref), sense of coherence (Antonovsky’s SOC-13), and depressive symptoms (Beck’s Depression Inventory II). Measurements were conducted at baseline and 3 and 9 months after baseline. The effects of the intervention were analyzed using generalized estimating equations (GEE).

Results

After 3 months, there was an intervention effect on environmental quality of life (group × time p = .048). Between 3 and 9 months, environmental quality of life decreased among RT1 compared to RT2 and RT3 (group × time p = .025). Between baseline and 9 months, environmental quality of life increased in RT2 compared to all other groups (group × time p = .011). Sense of coherence increased in RT2 compared to the control group and RT3 (group × time p = .032).

Conclusion

Resistance training is beneficial for environmental quality of life and sense of coherence. Attending resistance training twice a week seems to be the most advantageous for these aspects of psychological functioning.